DE3439533A1 - BONE CEMENT CONSISTING OF A POLYMERIZED PLASTIC MATRIX WITH INCORPORATED ACOUSTIC INTERFERENCE TO EASIER REIMPLANTATION OF JOINT DOPROTHESES - Google Patents
BONE CEMENT CONSISTING OF A POLYMERIZED PLASTIC MATRIX WITH INCORPORATED ACOUSTIC INTERFERENCE TO EASIER REIMPLANTATION OF JOINT DOPROTHESESInfo
- Publication number
- DE3439533A1 DE3439533A1 DE19843439533 DE3439533A DE3439533A1 DE 3439533 A1 DE3439533 A1 DE 3439533A1 DE 19843439533 DE19843439533 DE 19843439533 DE 3439533 A DE3439533 A DE 3439533A DE 3439533 A1 DE3439533 A1 DE 3439533A1
- Authority
- DE
- Germany
- Prior art keywords
- bone cement
- acoustic
- plastic matrix
- disruptive
- cement according
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Withdrawn
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/8802—Equipment for handling bone cement or other fluid fillers
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L24/00—Surgical adhesives or cements; Adhesives for colostomy devices
- A61L24/001—Use of materials characterised by their function or physical properties
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L24/00—Surgical adhesives or cements; Adhesives for colostomy devices
- A61L24/0047—Composite materials, i.e. containing one material dispersed in a matrix of the same or different material
- A61L24/0073—Composite materials, i.e. containing one material dispersed in a matrix of the same or different material with a macromolecular matrix
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2002/4631—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor the prosthesis being specially adapted for being cemented
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L2430/00—Materials or treatment for tissue regeneration
- A61L2430/02—Materials or treatment for tissue regeneration for reconstruction of bones; weight-bearing implants
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N7/00—Ultrasound therapy
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Public Health (AREA)
- Animal Behavior & Ethology (AREA)
- Veterinary Medicine (AREA)
- General Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Epidemiology (AREA)
- Chemical & Material Sciences (AREA)
- Materials Engineering (AREA)
- Composite Materials (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Prostheses (AREA)
- Materials For Medical Uses (AREA)
Description
3433533 #33433533 # 3
Knochenzement bestehend aus einer polymerisierten Kunststoffmatrix mit eingelagerten akustischen Störkörpera zur Erleichterung erforderlicher Reimplantationen von Gelenk— endoprο the s en.Bone cement consisting of a polymerized plastic matrix with embedded acoustic disruptive bodies to facilitate necessary reimplantations of joints endoprο the s en.
Ein zentrales Problem der Implantation von Gelenkend©-» prothesen besteht in der Verankerung der Prothese im Knochenlager. Der dafür bisher eingesetzte Knochenzement auf Methylmetacrylatbasis ist u.a. mit einem Starter für die Polymerisation (Copolymere und Additive) anger ei chert und dient in der orthopädischen Chirurgie zur sicheren und schnellen Primärfixierung des Gelenkimplantates am Knochen,A central problem of the implantation of the joint end © - » prosthesis consists in anchoring the prosthesis in the Bone Storage. The methyl methacrylate-based bone cement that has been used to date for this purpose comes with a starter for the polymerization (copolymers and additives) enriched and used in orthopedic surgery for safe and secure rapid primary fixation of the joint implant to the bone,
■jjj wodurch dem Patienten eine Frühbelastung des Gelenkes ermöglicht wird. Das in der Anrührphase zunächst noch teigige, langsam aushärtende Methylmetacrylat füllt den Raum zwischen Knochen und Gelenkimplantat nahezu fugenlos aus, erhält jedoch durch den fortlaufenden Polymerisationsvor— gang sehr schnell die volle Festigkeit. Diese Art der Fixierung von Gelenkendoprothesen am Knochen mittels aus~ polymerisiertem Polymethylmetacrylat (Knochenzement) ist heute weltweit angewandte und anerkannte Operationstechnik in der orthopädischen Chirurgie. Probleme wie zu hohe Energiefreisetzung und damit zu hohe Temperatur bei der Polymerisation, die zur Nekrotisierung des Gewebes führt, sind ebenso wie die Fragen der ausreichenden Biokompatibilität des Knochenzementes prinzipiell gelöst. Langfristig kann es jedoch zu Auslockerungen des Metallimplantates oder des Kunststoffimplantates im Polymethylmetacrylatlager kommen,, weswegen Prothesenwechsel mit Entfernung des Knochenzementes erforderlich werden. Die Entfernung des Knochenzementes aus Röhrenknochen ist technisch sehr schwierig und bedeutet eine lange Operationszeit bei Reoperationen von Gelenkendoprothesen, wodurch die überwiegend alten Patienten erheblich gefährdet sind durch lange Operationszeiten, lange Blutungszeiten der unverschlossenen Weichteile und■ yyy, which enables the patient to put stress on the joint at an early stage will. The slowly hardening methyl methacrylate, which is initially still doughy in the mixing phase, fills the space between the bone and the joint implant is almost seamless, but is retained by the continuous polymerisation process. full strength very quickly. This type of fixation of joint endoprostheses on the bone by means of ~ polymerized polymethyl methacrylate (bone cement) today globally used and recognized surgical technique in orthopedic surgery. Problems like too much energy being released and thus the temperature during the polymerization, which leads to the necrotization of the tissue, is too high as well as the questions of sufficient biocompatibility of the bone cement have been solved in principle. In the long term it can however, to loosening of the metal implant or the Plastic implants in the polymethyl methacrylate warehouse, which is why it is necessary to change the prosthesis with the removal of the bone cement. The removal of the bone cement from long bones is technically very difficult and means a long operation time for reoperations of Joint endoprostheses, whereby the predominantly old patients are considerably endangered by long surgery times, long bleeding times of the unclosed soft tissues and
erhöhte Infektionsgefahr durch lange Wundöffnungszeiten. Die Bedeutung dieses Problems läßt sich daran ermessen, daß bis zu 20 °/o aller heute durchgeführten Gelenkprothesenoperationen Reoperationen sind·increased risk of infection due to long wound opening times. The importance of this problem can be gauged in mind that up to 20 ° / o of all completed today prosthetic joint operations reoperations are ·
Die vorliegende Erfindung löst das Problem der Knochenzemententfernung bei Reoperationen mit einem neuen Typ von Knochenzement, der gekennzeichnet ist durch die Einlagerung von Körpern definierter Geometrie, um die Kerbwirkung in der Kunststoffmatrix für die normale mechanische Beanspruchung zu minimieren, deren Schallwellenwiderstand, d.h. das Produkt Dichte χ Schallgeschwindigkeit, sich von dem der Kunststoffmatrix jedoch deutlich unterscheidet. Durch die Beaufschlagung dieses Knochenzementes mit extrakorporal erzeugten Stoßwellen mit an die Geometrie der akustischen Störkörper angepaßten Profilen können an den akustischen Grenzflächen Zug- und Druckspannungen erzeugt werden, die zum Zerfall der Kunststoffmatrix führen.The present invention solves the problem of bone cement removal for reoperations with a new type of bone cement, which is characterized by its storage of bodies of defined geometry in order to achieve the notch effect in the plastic matrix for normal mechanical stress to minimize the acoustic wave resistance, i.e. the product density χ speed of sound, differs from the the plastic matrix, however, is clearly different. By applying this bone cement with extracorporeal generated shock waves with profiles adapted to the geometry of the acoustic disruptive body can be transmitted to the acoustic Interfaces tensile and compressive stresses are generated, which lead to the disintegration of the plastic matrix.
Im Prinzip wäre der auf dem Markt befindliche Nierenlithotripter zur Therapie des Harnsteinleidens auch für die hier gewünschte Zerstörung der Kunststoffmatrix des Knochenzementes einsetzbar, wenn die Stoßwellenprofile den akustischen Störkörpern angepaßt würden. Die Kosten dieses Gerätes gestatten jedoch nicht seinen umfassenden Einsatz in der Orthopädie' als Reoperationshilfe für Gelenkendoprothesen. Da Stoßwellenerzeugung und -fokussierung nur einen Bruchteil der Kosten des im Nierenlithotripter erforderlichen Stereoröntgenortungs- und Patientenpositionierungssystems ausmacht, wird für die erfindungsgemäße Aufgabe ein optisch-mechanisches Positionierungssystem vorgesehen. Mit den in orthopädischen Kliniken verfügbaren Röntgen- und Ultraschalldiagnosegeräten wird die Lage des Knochenzementpfropfens im Röhrenknochen bestimmt und auf der Hautoberfläche markiert. Mit einer Dickenmessung des Binde- und Knochengewebes zwischen Haut oberfläche und Knochenzement über den Gesamtumfang der Gelenkendoprothese sind die vomIn principle, the kidney lithotripter on the market would be for the therapy of urinary stone disease also for the destruction of the plastic matrix of the bone cement desired here can be used if the shock wave profiles would be adapted to the acoustic disruptive bodies. The cost of this device however, do not allow its extensive use in orthopedics as a reoperative aid for joint endoprostheses. Because shock wave generation and focusing are only a fraction of the cost of what is required in the kidney lithotripter Stereo x-ray tracking and patient positioning system makes one for the task according to the invention opto-mechanical positioning system provided. With the X-ray and ultrasound diagnostic equipment available in orthopedic clinics the position of the bone cement plug in the long bone and on the surface of the skin is determined marked. With a thickness measurement of the connective and bone tissue between the skin surface and the bone cement over the entire circumference of the joint endoprosthesis are those from
if Ό if Ό
Fokuspunkt der Stoßwellen zu überstreichenden Volumina eindeutig geometrisch zur Hautoberfläche festgelegt. Mit einer.Optik, die entweder in das Stoßwellenerzeugungs- system integriert oder mit ihm auf einer Wechselschiene fest verbunden wird f kann der Fokuspunkt der Stoßwellen exakt in den zu zerstörenden Knochenzement positioniert werden·Focal point of the shock waves to be swept volumes clearly defined geometrically to the skin surface. With optics that are either integrated into the shock wave generation system or firmly connected to it on an interchangeable rail f the focal point of the shock waves can be precisely positioned in the bone cement to be destroyed
Eine ebenfalls kostengünstige Alternative zu dem optischmechanischen Positionierungssystem ist ein in die Stoßwellenerzeugung integriertes Ultraschallortungssystem«Another inexpensive alternative to the opto-mechanical Positioning system is a used in shock wave generation integrated ultrasonic location system "
Durch eine extrakorporale Stoßwellenbehandlung des Knochenzementes eines Patienten kurz vor der Reoperaiion seines Implantates ist die einfache und sichere Entfernung des vorher verwendeten Knochenzementes gewährleistet«Through an extracorporeal shock wave treatment of the Bone cement of a patient shortly before the re-operation his implant ensures the simple and safe removal of the previously used bone cement «
Ausführungsbeispiel:Embodiment:
Kunststoffmatrix: Polymethylmetacrylat mit Antibiotikazusatz
Störkörper: Rotationsellipsoid, entstanden durch Rotation einer Ellipse mit den Halbachsen
1 mm und 2 nun um die kleinere Achs® ' Material TiA15Fe2,5.Plastic matrix: polymethyl methacrylate with added antibiotics
Disruptive body: ellipsoid of revolution, created by rotating an ellipse with the semiaxes 1 mm and 2 now around the smaller Achs® 'material TiA15Fe2,5.
Stoßwelle; Druckbereich iü 1 kbarShock wave; Pressure range iü 1 kbar
Druckanstiegszeit £· 10 see Halbwertsbreite ·< 10" see.Pressure rise time £ 10 see Half width · <10 "see.
Claims (9)
Priority Applications (7)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE19843439533 DE3439533A1 (en) | 1984-10-29 | 1984-10-29 | BONE CEMENT CONSISTING OF A POLYMERIZED PLASTIC MATRIX WITH INCORPORATED ACOUSTIC INTERFERENCE TO EASIER REIMPLANTATION OF JOINT DOPROTHESES |
EP85905616A EP0198912B1 (en) | 1984-10-29 | 1985-10-24 | Process for mechanically desintegrating plastic |
AT85905616T ATE50914T1 (en) | 1984-10-29 | 1985-10-24 | METHOD OF MECHANICAL DESTRUCTION OF POLYMERIZED PLASTICS. |
JP60505233A JPS62500638A (en) | 1984-10-29 | 1985-10-24 | Mechanically crushable bone cement |
PCT/EP1985/000561 WO1986002560A1 (en) | 1984-10-29 | 1985-10-24 | Mechanically desintegratable bone cement |
DE8585905616T DE3576460D1 (en) | 1984-10-29 | 1985-10-24 | METHOD FOR MECHANICALLY DESTROYING POLYMERIZED PLASTICS. |
US06/887,157 US4868237A (en) | 1984-10-29 | 1985-10-24 | Mechanically disruptible bone cement |
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE19843439533 DE3439533A1 (en) | 1984-10-29 | 1984-10-29 | BONE CEMENT CONSISTING OF A POLYMERIZED PLASTIC MATRIX WITH INCORPORATED ACOUSTIC INTERFERENCE TO EASIER REIMPLANTATION OF JOINT DOPROTHESES |
Publications (1)
Publication Number | Publication Date |
---|---|
DE3439533A1 true DE3439533A1 (en) | 1986-04-30 |
Family
ID=6249005
Family Applications (2)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
DE19843439533 Withdrawn DE3439533A1 (en) | 1984-10-29 | 1984-10-29 | BONE CEMENT CONSISTING OF A POLYMERIZED PLASTIC MATRIX WITH INCORPORATED ACOUSTIC INTERFERENCE TO EASIER REIMPLANTATION OF JOINT DOPROTHESES |
DE8585905616T Expired - Fee Related DE3576460D1 (en) | 1984-10-29 | 1985-10-24 | METHOD FOR MECHANICALLY DESTROYING POLYMERIZED PLASTICS. |
Family Applications After (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
DE8585905616T Expired - Fee Related DE3576460D1 (en) | 1984-10-29 | 1985-10-24 | METHOD FOR MECHANICALLY DESTROYING POLYMERIZED PLASTICS. |
Country Status (5)
Country | Link |
---|---|
US (1) | US4868237A (en) |
EP (1) | EP0198912B1 (en) |
JP (1) | JPS62500638A (en) |
DE (2) | DE3439533A1 (en) |
WO (1) | WO1986002560A1 (en) |
Families Citing this family (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5019083A (en) * | 1989-01-31 | 1991-05-28 | Advanced Osseous Technologies, Inc. | Implanting and removal of orthopedic prostheses |
US5163933A (en) * | 1990-10-22 | 1992-11-17 | Cedars-Sinai Medical Center | Prosthetic joint replacement procedure using excimer laser |
US6713527B2 (en) | 1997-02-07 | 2004-03-30 | Queen's University At Kingston | Anaesthetic bone cement |
DE19911779A1 (en) * | 1999-03-17 | 2000-09-28 | Daimler Chrysler Ag | Separation of components adhering to one another, enabling e.g. apparently-spontaneous car body disassembly, is achieved by built-in source of ultrasound or laser light which degrades and cleaves adhesive bonds |
WO2018175619A1 (en) * | 2017-03-22 | 2018-09-27 | Edwards Lifesciences Corporation | System and method for implanting and securing a bioprosthetic device to wet tissue |
Family Cites Families (6)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
DE2752297C2 (en) * | 1977-11-23 | 1991-06-20 | Dobrivoje Dr. 8000 München Tomic | Material as cancellous cement with foaming and resorbable effect and its use |
EP0006414B1 (en) * | 1978-06-29 | 1984-10-10 | Osteo Ag | Carbon fiber reinforced bone cement |
DE2947885A1 (en) * | 1979-11-28 | 1981-07-23 | Sigri Elektrographit Gmbh, 8901 Meitingen | Carbon fibre reinforced bone cement prodn. - by impregnating with acrylate monomer and coating with curable polyacrylate bone cement under tension |
US4341691A (en) * | 1980-02-20 | 1982-07-27 | Zimmer, Inc. | Low viscosity bone cement |
DE3128923A1 (en) * | 1981-07-22 | 1983-02-10 | Beiersdorf Ag, 2000 Hamburg | POWDER BLEND FOR SURGICAL PURPOSES |
FR2516796B1 (en) * | 1981-11-20 | 1986-06-06 | Altulor Sa | COMPOSITIONS FOR SURGICAL CEMENT BASED ON AT LEAST ONE ACRYLIC MONOMER AND AT LEAST ONE ACRYLIC POLYMER |
-
1984
- 1984-10-29 DE DE19843439533 patent/DE3439533A1/en not_active Withdrawn
-
1985
- 1985-10-24 EP EP85905616A patent/EP0198912B1/en not_active Expired - Lifetime
- 1985-10-24 DE DE8585905616T patent/DE3576460D1/en not_active Expired - Fee Related
- 1985-10-24 WO PCT/EP1985/000561 patent/WO1986002560A1/en active IP Right Grant
- 1985-10-24 US US06/887,157 patent/US4868237A/en not_active Expired - Fee Related
- 1985-10-24 JP JP60505233A patent/JPS62500638A/en active Pending
Also Published As
Publication number | Publication date |
---|---|
WO1986002560A1 (en) | 1986-05-09 |
JPS62500638A (en) | 1987-03-19 |
DE3576460D1 (en) | 1990-04-19 |
EP0198912A1 (en) | 1986-10-29 |
US4868237A (en) | 1989-09-19 |
EP0198912B1 (en) | 1990-03-14 |
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Legal Events
Date | Code | Title | Description |
---|---|---|---|
8139 | Disposal/non-payment of the annual fee |